[Question #12921] HIV risk from oral

3 months ago

I had this cut (actually seems like infected fimbriata) on my tongue, I went to urgent and the NP ripped it off. 3 days later I gave oral sex and he ejaculated in my mouth.

What’s the risk of HIV from this?

3 months ago

I should say I did speak to OHIV and they said the cut would need to have required stitches but for some reason I can’t accept that

3 months ago

Any sex guidance keeps talking about micro cuts and it’s freaking me out

H. Hunter Handsfield, MD

3 months ago

Welcome to the forum. Thank you for your confidence in the forum and for your question.

You are seriously overreacting. Oral sex is inherently low risk for all STDs and transmission of HIV is exceedingly rare and a recent cut or sore in the mouth probably makes no difference at all. In theory, such a lesion might somewhat increase the risk, but still your chance of catching HIV was under one chance in 10,000; and even that is only if your partner is infected and untreated. It seems clear you are being misled by online searching, probably mostly seeing unprofessional websites or other unreliable information.

From a medical/risk perspective, I would not even advise HIV testing. Of course you are free to be tested anyway; reassurance is a valid reason, even when the risk is near zero. If you decide to test, you can have a conclusive HIV PCR RNA test 11 days after the event; or an antigen – antibody (4th generation) test at six weeks. Or speak with your partner about his HIV status; if not infected, or if he gets tested now with the expected negative result, you would know you were not at risk.

I hope this information loves you to relax, stop worrying, and sleep well. Let me know if anything isn’t clear.

HHH, MD

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3 months ago

Can you explain why a healing cut does not pose a risk for hiv, and what type of cut people talk about for risk with hiv?

H. Hunter Handsfield, MD

3 months ago

There are no research studies on which to base the reasons. But we know that performing oral sex, with ejaculation of HIV infected semen in the mouth (and swallowing it) has an estimated risk of one chance in 10,000 of being infected, there have been very few actual proved cases. These figures are despite the fact that sores in the mouth are extremely common, so there have been billions of such events in the presence of sores -- with nothing to suggest the risk is any higher.

In fact, I am unaware of any scientific information that suggests exposure of cuts really is risky. This is an assumption, not a proved fact -- even if some websites imply it is a well documented risk. Apparently it is not; I have never seen nor even heard rumors of anyone who actually caught HIV because of exposure of a preexisting wound to the virus. I suppose it might happen, but it has to be exceedingly rare.

You really needn't worry about this. I also suggest you limit your online searching to professional sites, like academic and public health agencies; or those that are professionally moderated, like this one. Anyone can write online anything they believe (or want to mislead people about), and "Doctor Google" definitely is not a friend to anxious persons. For sure avoid sites run by and for people with HIV or at risk -- like Reddit for example.

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3 months ago

By day 3, is a cut healed enough to have not been considered a risk anymore?

Also, is oral sex considered risk free for hiv?

3 months ago

Here is what OHIV.org says:

Oral sex is not considered an at-risk behavior for HIV. The only known cases of HIV transmission during oral sex happened when someone recently had a mouth or throat surgery & still had stitches. Otherwise, it is virtually impossible for HIV to transmit during oral sex!

H. Hunter Handsfield, MD

3 months ago

The last comment does not change my assessment or advice. A single such case in the 40+ years of the world wide HIV/AIDS epidemic means nothing. Millions of oral exposures when sores were present undoubtedly have occurred -- and only one such case reported in the medical literature? Forget it.

As for "oral sex is not considered an at-risk behavior", I cannot answer any better than I did above. Re-read my comments above, starting with the sentence after "You are overreacting" and then the next reply, starting with "There are no research studies...." I haven't changed my mind since those replies!

That completes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.

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